TKR surgery

[Wolf68]

Hello all, I had my TKR surgery Thursday and all has gone smoothly, I got back home last night and so far the pain has not been too bad. I am using tramadol and paracetomol in a staggered sequence and it seems to manage it reasonably well.

The staff at the hospital were brilliant and the physiotherapist has told me to just use my crutches for walking around the house for now and given me 3 different exercises to do beforei have a physio appointment next week.

Just one little niggle this morning I think I noticed a slight click when I was getting out of bed and my first couple of steps with my crutches , I did bend and straighten my knee a few times first while lying in bed because it was quite rigid after sleeping but I just wondered if I should contact the hospital or should i expect this and see how it goes? My new knee is a cobalt chromium alloy with a plastic knee cap, not sure if that means anything but my surgeon said it was successful and the post op x-rays are all ok.

[piglette]

I am so glad things went well. It is quite a painful op. The knee replacement is made of a metal alloy Cobalt/Chromium and then plastic - polyethylene. My company was involved in the training of surgeons throughout Europe. We used to do it in Eastern European countries as everyone has to have a post mortem, so it was easier to find bodies for the training!

[Wolf68 in reply to piglette]

Thank you for the reply and for your work in this field !

The pain and stiffness has gotten worse since I returned home from the hospital but I have been told to expect that and it is quite normal. I am not bending the knee as well as I was because of the increased swelling but can still straighten it completely. Anyway I’m back at the hospital in a couple of hours so they can let me know if I’m doing anything wrong.

[DorsetLady in reply to Wolf68]

Maybe you need more icing around the joint to decrease the swelling. Fingers crossed the visit to hospital will help, if only to discover why you are having issues, but hopefully to sort it out.

[piglette in reply to Wolf68]

Good luck at the hospital

[FraserB]

I just got out of the hospital after having a total knee replacement as well, and today is day 4 for me. I also noticed and felt an odd sensation in my knee, which I believe is due to the ligaments, tendons and muscles still not being fully developed yet. The swelling and pain are similar to what you've mentioned, and that’s completely normal. It's good you're getting it checked out.

I'm also not able to bend my knee as much, which is due to the swelling. If you're able to straighten it fully, you're doing well so far. Ice and cold therapy are my best friends, along with elevation.

[Wolf68 in reply to FraserB]

It sounds like we’re going through similar things right now. Yesterday was my worst day yet since surgery. The pain was bad but I still managed a few physio exercises while I was at the hospital and at home. Just like you I am finding ice packs very helpful.

The hospital removed my catheter yesterday and got me to sip water and scanned my bladder once I had passed water. Problem was I wasn’t passing enough and all the water made me sick a few times. Eventually my bladder was empty enough to let me go home but as I was still throwing up I went straight to bed without food or drink and eventually started to feel better. The weird thing is, is that throughout the night I was having to pass water every hour or so even though I hadn’t had any fluids for hours.

I did manage some sleep in between going to the bathroom and the knee does seem a little better today. Hopefully with pain relief and ice things improve today. The hospital staff seemed happy enough with the knee, everything seemed normal to them and they said it is just a case of doing enough exercises to improve the movement but not pushing it too hard to cause excessive swelling.

[FraserB in reply to Wolf68]

Glad to hear the hospital staff were happy with your knee. I can definitely relate to the pain. I experience some pain, but thankfully it’s short-lived and is managed with my painkillers. I’m able to prep my own meals (nothing fancy) and get around my home with a walker. However, I find that I’m very tired most of the time, which makes sense since it’s a major surgery.

I understand what you mean about feeling ill. After I was discharged and driven home by a friend, I felt nauseous the entire trip. I think it’s a combination of the medications, the environment, and the surgery itself. I was relieved to finally get home.

The hospital staff mentioned the importance of exercises to improve movement, but emphasized not pushing too hard, and I agree that this is key. On day 3, I overdid it and the swelling increased significantly, so I spent the rest of the day using cold packs and elevating my leg. I’m still figuring out how much to push myself and when to back off, but the physiotherapist will be helping with that. I have to remind myself that I’m still in the very early stages of recovery, and I shouldn’t expect too much at this point.

All the best with your recovery. The first couple of weeks are a challenge, but I know it will get better with time. Even with all of this, I don't regret getting it done. I could barely walk before.

[Wolf68]

I had a physio appointment yesterday and had a bit of a telling off because I have excessive swelling which apparently is lymphoedema, I was told I should have gone to a doctor or hospital to get this checked because it is unusual but I just thought the level of pain and swelling is normal after surgery like a TKR. Anyway the swelling is restricting my bend in the knee so I need to get this down and pick up on my lunges, I have been moving around the house a lot as I was told to do, and doing my exercises regularly throughout the day, I am icing regularly and I have now increased the times I am elevating the leg, I am trying to massage up from the ankle to the groin area but there are parts near to the knee that are tender so that isn’t easy.

I wear the compression stockings all day and night as told and I am still injecting inhixa for thinning my blood (I have previously had a blood clot in that leg ), but so far the pain and swelling has not improved. Could these problems be linked to the previous blood clot? Is there anything else I can do to improve this?

[Croqgirl]

I'm sorry to hear that you have developed lymphoedema as a result of your surgery, but I am impressed that your physio has picked up on it so quickly and has got you wearing compression, which is the main way to manage it.I too developed lymphoedema as a result if a TKR 2 years ago, but it took many months of persistence on my part to get a diagnosis and then treatment.

Lymphoedema does not go away, and it is a condition that needs to be managed using compression. Ice packs will only help with the swelling related to the surgery, not the swelling related to the lymphoedema, and my understanding is that extreme cold is not helpful for the condition, (I wish I had known this, I iced and iced in a failed effort to reduce the swelling. ) I suggest that you seek advice about this, but if I had known what I know now I would have used cold packs rather than ice packs. There are some excellent support groups for lymphoedema including LSA, and a couple of good books that you can read. St George's hospital in London is a centre of excellence in the UK.

Another way to try to reduce the swelling is through manual lymphatic drainage (MLD). Make sure you choose someone who is qualified in this type of massage. You can find a list on the LSA website. It did not help me but everyone is different and it could be worth a try.

Also, try not to overdo the exercise. There is a balance to be struck, and too much exercise can increase the swelling. Now that I am recovered from my TKR I find exercise and weight management as well as compression very helpful in managing my symptoms. Do lots of research and find what works best for you.

[Wolf68]

I am almost 3 weeks on after surgery and I am still getting excessive swelling after exercising, is this normal?

I have been doing my physio exercises regularly and most of the straightening and quad strengthening exercises are reasonably easy, I am also able to walk slowly with one crutch to the end of my street and back which is roughly around 1500 steps, however the bending exercises are still very difficult because of the swelling in and around the knee and it seems to increase as the day goes on.

I had my staples removed Friday and the wound has healed very nicely but the nurse said the knee was still very swollen.

I am elevating and icing regularly throughout the day but it doesn’t seem to be making much difference. I am also still finding it difficult to get comfortable at night so I am not getting much sleep. Is all this normal nearly 3 weeks after surgery or should I be making more progress?